Herpes zoster: an early manifestation of HIV infection
- PMID: 12294921
Herpes zoster: an early manifestation of HIV infection
Abstract
PIP: Herpes zoster, also known as shingles, is a reactivation of a previous infection with the herpes varicella-zoster virus. A person's first encounter with the virus causes chicken pox, usually in children. Once the chicken pox has healed, the virus remains in the posterior root ganglion of the spinal cord for the rest of the person's life. If a person's immunity is reduced for any reason, the virus can be reactivated, travel down one of the sensory nerves to the skin and cause herpes zoster. Herpes zoster cannot be contracted from someone who has it, for the infection always comes from one's own spinal cord. However, chicken pox can be caught from someone with herpes zoster. Before signs of herpes zoster become apparent on the skin, there is pain along the course of one of the sensory nerves of the skin. A rash then appears 2-3 days later, beginning with grouped vesicles either confined to 1 dermatome or spread over 2 adjacent dermatomes. The vesicles will later crust over before healing in 3-4 weeks. The rash remains painful until it has healed. Herpes zoster-related problems at the eye, tongue, chest and abdomen, and bladder and bowel are noted. In Africa, the presentation of a patient with herpes zoster should always lead the clinician to suspect HIV infection, for since the beginning of the AIDS pandemic, herpes zoster has often been the first manifestation of HIV infection. Various treatments with analgesics and topical and antiretroviral agents are described.
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